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USING VIDEO FEEDBACK IN CBT FOR SOCIAL ANXIETY

The Cost of Misperception

One of the key components that maintains Social Anxiety Disorder over time is a pervasive negative self-image and related self-critical thoughts that are activated in social situations. Once activated, this negative self-image often leads to overly negative misperceptions of how one is coming across to others during social contacts. Increased apprehension and avoidance of social interactions often increases from this habitual negative perception of oneself, perpetuating further the cycle of social anxiety.

Watching and Learning

Fortunately, several strategies have been developed within Cognitive-Behavioral Therapy (CBT) that are helpful to adjust one’s perceptions to a more helpful and realistic appraisal. A recent study by Warnock-Parkes et al. (2017) focused on the benefit of using video feedback in particular within CBT. They found that using video feedback with participants was highly effective in changing negative self-perceptions and was associated with a significant reduction in social anxiety. Participants reported an improvement in their self-perception as they learned that they came across to others more favorably than they originally predicted, once they viewed video of themselves during a social interaction. The author’s identified the following guidelines for using video feedback during cognitive-behavioral therapy:

Setting up the Camera

Along with setting up the camera in an unobtrusive place, it is best to show both people in the interaction so the participants can focus on the overall context of the interaction (versus overly focusing on themselves).

Identify Predictions in Advance of Viewing

Identify what participants think they will see and what their self-perceptions are (eg. “I’ll look terribly anxious and shaky”).

Prepare an Unbiased Mode of Viewing

Individuals with social anxiety often use their feelings as a judge of social performance, versus concrete goals or how one objectively appears. Before viewing their video, help participants to distance from the videotaped interaction and appraise the video as if it were of a stranger, ignoring their feelings.

Compassionate Stance

Direct the participant to view the video from a compassionate stance, as if watching a close friend as a means of counteracting habitual self-critical thoughts.

Identify Impact of “Safety Behaviors”

Participants may intentionally respond to social interactions with ways to help reduce anxiety, such as avoiding eye contact. Watch out for the unintentional impact of these safety behaviors on the interaction.

Compare and Contrast

Compare predictions and ratings of the interaction before and after viewing the video: participants reliably found they looked much better than they thought they would!

People with social anxiety can have great difficulty separating their anxious feelings and negative self-perceptions from what their actual behavior and presentation is in social interactions, whether they are in the therapy office or out in public. Utilizing video feedback within the structure of CBT offers a great strategy to move beyond these feelings and gain a more helpful and accurate view of oneself in social situations.